Sense About Science is a UK registered charity that works to
equip people to make sense of science and evidence. We work with over 4,000
scientists, from Nobel prize winners to our Voice of Young Science network of
postdoctoral researchers, to help civic groups including community
organisations, media and commentators to weigh up claims about evidence.

2.1 Public
perception of homeopathy

We monitor public discussions, together with our own log
of requests for help and concerns raised by scientists, to identify frequently
occurring misconceptions or misleading information. In 2006 we reviewed discussion
about homeopathy and made two observations:

a) That it was believed to
contain an active ingredient, and was often confused with herbal medicine (and,
related to this, that people were often unaware of the mystical belief in water
memory and in 'like cures like' on which it is based).

b) That because it was supplied on the National
Health Service, it was assumed that it 'must be effective' and 'there must be
something in it'.

2.2 We also noted regular
reports of homeopathic remedies being marketed for serious diseases, notably at
that time anti-malarial prophylaxis. We assessed this to be in part a consequence
of the assumptions a) and b) above.

2.3 We noted, through
discussions held with clinicians and researchers, that there was an atmosphere
of resigned frustration about the possibility of addressing the misconception
that homeopathic products contain active ingredients and the misconception that
there was reliable evidence of efficacy beyond the placebo effect. In
particular they found it hard to argue against something that was supplied
through the NHS and that appeared to be officially endorsed. We also noted
their frustration about the acclaimed 'holistic' approach of homeopathy despite
its inability to diagnose disease and the potentially dangerous consequences of
that. Furthermore, if the use of some unproven and unlikely remedies is
officially flattered and endorsed, then this affects our ability to reason
through debates about the suitability or provision of any other remedy. In
other words, one cannot demand that people accept the evidence regarding the
provision of drugs for Alzheimer's yet overlook it regarding the provision of
homeopathy.

2.4 Scientists' resignation to
public misconceptions is anathema to Sense About Science's mission of equipping
the public to make sense of science and evidence. It disenfranchises the public
by removing scientific reasoning to senior common rooms and private clubs.

3. Challenging perceptions

We supported and encouraged
medical scientists to make themselves plain in public discussions about
homeopathy in the following ways:

3.1 In May 2006, a group of medical specialists,
led by cancer surgeon Professor Mike Baum, writing to the medical directors and
directors of public health at NHS trusts to draw attention to the provision of
homeopathy and the lack of evidence in support of its efficacy. In particular
they raised concern about: overt promotion of homeopathy for general use in the
NHS, including on the NHS Direct website; a government-funded patient guide,
prepared by the Foundation for Integrated Health; and the Smallwood report
commissioned by the Prince of Wales to make a case for increasing NHS provision
of homeopathy. They pointed out that over a dozen systemic reviews had failed
to provide convincing evidence of effectiveness. This letter was followed one
year later with a letter led by Professor Gus Born, enclosing a copy of an
evidence review by a London NHS trust.

3.2 From this time, a group of clinical
researchers and journalists gathering information on the extent of provision of
homeopathy by NHS trusts, a summary of which has been supplied to you separately.

3.3 In July 2006, working with experts in malaria
and tropical diseases to warn the public that homeopathic medicines offer no
protection against malaria or other serious tropical diseases. This followed a
short investigation by Sense About Science, which showed that the first ten
homeopathic clinics and pharmacies selected from an internet search and
consulted were willing to break public health protocols by providing unproven
homeopathic pills to protect against malaria and other tropical diseases such as
typhoid, dengue fever and yellow fever. In widely report comments, the malaria
experts called on the Government to ensure that the safety of the travelling
public was not put at risk by such prescriptions. Subsequent action was brought
by the Royal Pharmaceutical Society of Great Britain (the pharmacy registration
body at that time) against two of the pharmacies investigated. This is ongoing.

3.5 In
autumn 2006, challenging the Medicines for Human Use (National Rules for
Homeopathic Products) Regulations 2006. The new regulations permitted
homeopathic products to make medical claims but exempted them from providing
scientific evidence that they are effective. This was the first time in its
history that the regulation of medicines moved away from science and from
clear, meaningful information for the public. What is more, it happened without
parliamentary time or public debate. In October 2009, Sense About Science
summarised for parliament hundreds of responses protesting the introduction of
the regulations, including many from scientific and medical bodies. These were
instrumental in pressing for the debate that was held in the House of Lords on
26th October 2006. The serious
concerns of the scientific and medical community were raised by Lord Taverne
(Chairman of Sense About Science), Lord Rees of Ludlow (President of the Royal
Society), Lord Turnberg, Lord Jenkin of Roding, Lord McColl of Dulwich and
Baroness O'Neill of Bengarve. A summary of our objection at that time was:

"The regulations

The mission of the UK's licensing
body, the Medicine and Healthcare products Regulatory Agency (MHRA), is to
ensure "that medicines and medical devices work, and are acceptably safe".
However, with the introduction of the new rules for homeopathy, it now accepts
homeopathic provings as evidence of efficacy. A 'proving' is the method
homeopaths use to determine the symptoms a substance causes (with a view to
treating diseases with similar symptoms). Provings are not carried out on the
finished product and are nothing to do with efficacy.

The regulations also mean that, for
the first time in more than 30 years, homeopathic products will be able to make
medical claims such as "For the relief of...". Such claims, however worded, imply
efficacy where none has been proven.

The MHRA did not have to change the
regulations in this way. It was not required to do so by EC Directive 2001/83.
The MHRA set out four options to government, including doing nothing. It chose
to eliminate the old, stricter licences in order to facilitate the "expansion
of the homeopathic industry" through new products.

The MHRA has designed the regulations
to respond to pressure from the homeopathic industry, which wants to expand
(see impact assessment right)."

3.6 In June 2009 working with
Voice of Young Science to urge the World Health Organisation to respond to the
promotion of homeopathy in developing countries for infant diarrhoea,
influenza, HIV, tuberculosis and TB. A note from Julia Wilson of VoYS is
appended.

Submission
to Evidence Check: The evidence base on homeopathic products and services

1. SUMMARY

A group of young researchers have received
comments from directors of WHO disease programmes stating that they do not
recommend homeopathy for the treatment of HIV, influenza, TB, Malaria and
Infant diarrhoea. These comments have been sent to all health minsters in the
world and provide a guideline for governments and health care workers dealing
with these issues.

2. BACKGROUND

Voice of Young Science (VoYS) is a network
of over 600 early career researchers set up by Sense About Science. Sense About
Science is a charity that equips people to make sense of science and evidence.VoYS
became aware of a conference[1]
promoting the use of homeopathy in developing countries and discovered that
homeopaths are setting up clinics in these countries and claiming to treat HIV,
malaria, TB, influenza and infant diarrhoea. Medics working with the most rural
and impoverished people of the world already struggle to deliver the medical
help that is needed. The promotion of homeopathy for serious diseases puts
lives at risk.On 1st
June 2009 25 early career researchers and medics from the UK and Africa
sent an open letter to the World Health Organisation (WHO) calling on the body
to condemn the promotion of homeopathy for treating life threatening diseases.
Their letter available at http://www.senseaboutscience.org.uk/index.php/site/project/331/
had the support of leading international experts in malaria, HIV and other
serious diseases.

3. RESPONSE

VoYS received supportive comments from the
Stop TB Department, the TB Strategy and Health Systems, the HIV/AIDS
Department, the Global Malaria Programme and the Department of Child and
Adolescent Health and Development stating that they do not recommend homeopathy
for serious diseases. These comments are available at http://www.senseaboutscience.org.uk/index.php/site/project/392/.
The Director General's office confirmed that these 'clearly express the WHO
position'.

4. IMPACT

VoYS released the WHO response on 21st
August 2009. It was sent to the health ministers of all countries to highlight
the WHO's position on homeopathy and to call on governments to combat its
promotion for serious diseases. The WHO
response was covered widely in UK
and international media including African, Indian and South American news. VoYS
were contacted by a number of researchers and medics in Africa and India, organisations such as the Centre for
Inquiry in Nigeria
and several South African journalists, concerned about the promotion of
homeopathy in their countries and pleased to have this support.